RECORD OF PROCEEDINGS
AIR FORCE BOARD FOR CORRECTION OF MILITARY RECORDS
IN THE MATTER OF: DOCKET NUMBER: BC-2011-00095
COUNSEL: NONE
HEARING DESIRED: NO
_________________________________________________________________
APPLICANT REQUESTS THAT:
His claim for compensation under the Traumatic Servicemens
Group Life Insurance (TSGLI) program be honored.
_________________________________________________________________
APPLICANT CONTENDS THAT:
He experienced a qualifying traumatic event that resulted in a
traumatic injury that caused scheduled losses as defined under
the program.
His claim is a multi-loss claim involving a LeFort type II
fracture (avulsion, discontinuity defects to the left side of
his face and head, including multiple deep lacerations (open
wounds, discontinuity defects).
His claim also qualifies for a loss of Activities of Daily
Living (ADL) compensation, as his injuries involved a traumatic
brain injury (TBI).
In support of his request, the applicant provides a personal
statement, a memorandum, the TSGLI Procedural Guide, extracts
from his medical records, a fracture definition from the Free
Dictionary website, a Power Point presentation, an article from The Journal of Prosthetic Dentistry and various other documents
associated with his request.
The applicant's complete submission, with attachments, is at
Exhibit A.
_________________________________________________________________
STATEMENT OF FACTS:
The applicant is presently serving in the Regular Air Force in
the grade of master sergeant.
On 21 Jul 08, the applicant was involved in a roll-over logging
truck accident in the mountains of Utah.
The applicant submitted three claims for TSGLI compensation;
however, the claims were denied as they did not meet the
eligibility criteria.
On 10 Nov 10, HQ AFPC/DPSD advised the applicant his next level
of appeal was to the Air Force Board for Correction of Military
Records (AFBCMR).
Other relevant facts pertaining to this application are
contained in the advisory opinion prepared by the BCMR Medical
Consultant, which is at Exhibit D.
_________________________________________________________________
AIR FORCE EVALUATION:
HQ AFPC/DPWC recommends denial. DPWC states the applicants
losses do not meet the TSGLI eligibility criteria for payment.
The complete DPWC evaluation, with attachments, is at Exhibit B.
_________________________________________________________________
APPLICANT'S REVIEW OF AIR FORCE EVALUATION:
A copy of the Air Force evaluation was forwarded to the
applicant on 11 Mar 11 for review and comment within 30 days
(Exhibit C). As of this date, this office has not received a
response.
_________________________________________________________________
ADDITIONAL AIR FORCE EVALUATION:
The BCMR Medical Consultant recommends denial. He states the
applicant has not met the burden of proof that warrants the
desired change to the record. The applicants injuries were
potentially life-threatening; however, he received prompt
emergency care. None of his injuries presented a gross
disfigurement or required surgery to correct discontinuity loss
of the tissue of 50 percent or more under a certain
interpretation of an avulsion or discontinuity defect.
Regarding the applicants alternative contention for receiving
the benefit under loss of ADL, the BCMR Medical Consultant
states two of the following qualifying requirements must be met,
as a minimum at the 30th consecutive day or the 15th
consecutive day where there is a coma from trauma and/or TBI
resulting in inability to perform at least two activities of
daily living: unable to bathe independently, unable to maintain
continence, unable to dress independently, unable to eat
independently, unable to toilet independently, and unable to
transfer independently.
The applicant would have required hospitalization for
15 consecutive days. Based on the documentation, the
application falls short by one day of the benefit. His
hospitalization was from 21 Jul 08 through 3 Aug 08. However,
the Board has the authority to alter a predicate fact should
this serve the best interest of justice.
The BCMR Medical Consultant concedes the applicant may have been
unable to independently dress himself, or at best found this to
be a difficult task, particularly when putting on socks or
buttoning clothing with his dominant extremity. However, the
applicants unilateral peripheral (ulnar and median nerve)
neuropathy or likely neuropraxia should not have precluded
bathing more than one part of the body, nor should have it
interfered with maintaining continence, toileting or the
independent transfer in and out of bed or chair.
Further, there is no evidence provided to show the applicant
sustained a lasting cognitive or other functional deficit due to
the TBI that impaired his reasoning, thought processing,
computing, or other mental functions for the qualifying duration
of time.
The complete BCMR Medical Consultants evaluation, with
attachment, is at Exhibit D.
_________________________________________________________________
APPLICANT'S REVIEW OF ADDITIONAL AIR FORCE EVALUATION:
A copy of the BCMR Medical Consultants evaluation was forwarded
to the applicant on 8 Apr 11 for review and comment within
30 days (Exhibit E). As of this date, this office has not
received a response.
_________________________________________________________________
THE BOARD CONCLUDES THAT:
1. The applicant has exhausted all remedies provided by
existing law or regulations.
2. The application was timely filed.
3. Insufficient relevant evidence has been presented to
demonstrate the existence of error or injustice. The applicants
complete submission was thoroughly reviewed and his contentions
were duly noted; however, no evidence has been presented that
convinces us the applicant met the eligibility criteria for
traumatic injury protection under the TSGLI program. Therefore,
we agree with the opinions and recommendations of the Air Force
office of primary responsibility and AFBCMR Medical Consultant
and adopt their rationale as the basis for our conclusion the
applicant has not been the victim of an error or injustice. In
the absence of persuasive evidence to the contrary, we find no
basis to recommend granting the relief sought in this
application.
________________________________________________________________
THE BOARD DETERMINES THAT:
The applicant be notified that the evidence presented did not
demonstrate the existence of material error or injustice; that
the application was denied without a personal appearance; and
that the application will only be reconsidered upon the
submission of newly discovered relevant evidence not considered
with this application.
________________________________________________________________
The following members of the Board considered AFBCMR Docket
Number BC-2011-00095 in Executive Session on 2 Aug 11, under the
provisions of AFI 36-2603:
Panel Chair
Member
Member
The following documentary evidence was considered:
Exhibit A. DD Form 149, dated 23 Nov 10, w/atchs.
Exhibit B. HQ AF/DPWC, Letter, dated 28 Feb 11, w/atchs.
Exhibit C. SAF/MRBR, Letter, dated 11 Mar 11.
Exhibit D. BCMR Medical Consultant, Letter, dated 6 Apr 11.
Exhibit E. SAF/MRBR, Letter, dated 8 Apr 11, w/atch.
Panel Chair
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